[The supramalleolar flap. Our experience in 35 cases]. / Le lambeau supramalléolaire latéral. Notre expérience de 35 cas.
Ann Chir Plast Esthet
; 46(2): 112-24, 2001 Apr.
Article
en Fr
| MEDLINE
| ID: mdl-11340933
The authors report 35 cases of use of the supramalleolar flap described by Masquelet et al. in 1988. In 27 cases, the arterial blood supply was in a mixed (anterograde and retrograde) fashion since the perforating branch of the peroneal artery was spared. In eight cases the arterial blood supply was in a retrograde fashion due to the location of the skin loss. As described by Valenti et al. In 1991, the authors recommend the use of a distal subcutaneous pedicled to avoid skin grafting over the tendons at the distal part of the lag. In main cases of anterograde blood supply the superficial peroneal nerve could be spread. In 33 cases the plastic result was assessed as satisfactory. The coverage of the weight-bearing portion of the heel was done two times with no satisfactory result. Coverage of the medial malleolus area, Achilles tendon and dorsal skin of the foot represent the main indications and the best results. Five times, a venous congestion was observed with three cases of partial necrosis of the flap. The use of a large subcutaneous pedicle did not always prevent such venous problems, though this technical aspect improves the vascular reliability of the flap. The main local alternative is the distal pedicled sural flap that needs to divide the sural nerve and not allows coverage as distal as the supramalleolar flap. Except the distal coverage of the foot, the indications of these previous both flaps are similar. In case of foot coverage, the medial plantar flap based on the lateral plantar vascular bundle, as described by Martin et al. in 1991, is the other one local alternative. Free flaps are indicated for extensive skin losses, or when a poor distal vascularity of the leg does not allow reliability of distal pedicled flaps.
Buscar en Google
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Colgajos Quirúrgicos
/
Procedimientos de Cirugía Plástica
/
Traumatismos de la Pierna
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
Fr
Revista:
Ann Chir Plast Esthet
Año:
2001
Tipo del documento:
Article
País de afiliación:
Francia
Pais de publicación:
Francia